REST EASY WITHOUR NO-GAP JOINTS PROGRAM

We believe in taking a holistic approach to your health and wellbeing. So, when it comes to having primary hip or knee replacement surgery, we want to give eligible members* greater flexibility to make their experience simple and supported.

Our No-Gap Joints program for primary hip and knee replacements, gives eligible members peace of mind with no out-of-pocket costs^{^} from hospital admission through to discharge and post-surgery rehab, with participating private hospitals and clinicians*.

The No-Gap Joints program is scheduled to end between March and September 2025, depending on the participating hospital.

Eligible members are accepted into the program if they meet the clinical criteria outlined by participating clinicians and hospitals^* .

Members can get:

• primary hip and knee replacements with no out-of-pocket costs^{^} through participating private hospitals and clinicians in NSW and Vic
• costs covered^{^} during and after surgery, so you can focus on recovery
• continuity of care with the same health professionals and hospital coordinating your care from admission through to post-surgery rehab
• treatment with a participating surgeon in a holistic package including rehab.

Where can you access our No-Gap Joints program?

We know that giving you the choice of specialists, hospitals and services is important. That’s why we’ve partnered with these hospitals to make your primary hip or knee replacement experience as simple, affordable and supportive as possible.

• East Sydney Private Hospital, NSW
• Macquarie University Hospital, NSW
• Hurstville Private Hospital, NSW
  
• Vermont Private Hospital, Vic

After a fall left Janet in acute pain and needing knee replacement surgery, she discovered the benefits of our No-Gap Joints program.

Watch how the program helped Janet get back on her feet.

How do I know if I’m eligible for the No-Gap Joints program?  
Eligible members that have held HCF hospital cover including primary hip and knee replacements for at least 12 months are covered for No-Gap Joints, once they are accepted into the program in line with clinical criteria by a participating surgeon and hospital before the relevant program end date (excludes Overseas Visitors Health Cover members)^*. Please visit the participating hospitals' page to see the list of surgeons involved in the program.

Will I have any out-of-pocket costs?
Our No-Gap Joints program covers eligible members on their primary hip or knee replacement journey from hospital admission through to discharge and post-surgery rehab, with participating private hospitals and clinicians*.

HCF members who are eligible to participate in the program won’t have any out-of-pocket costs except for any hospital policy excess (an excess may apply depending on your level of cover and if you’re claiming for the first time in a calendar year), or any additional services. Additional services may be required if you have other medical conditions such as diabetes or cardiac conditions. These additional services are not covered by the No-Gap Joints program and additional costs may apply.

If there are complications during your hospital admission that require additional care or services beyond what's included in the No-Gap Joints program, there may also be additional costs. Please speak with your participating surgeon about any risks that may be associated with your chosen surgery.

The No-Gap Joints program includes:

• participating surgeon costs for primary hip or knee replacement surgery. This doesn’t include pre-surgical consultations but includes post-surgical consults
• diagnostics (pathology and radiology) for any inpatient diagnostics performed while admitted for the primary hip or knee replacement surgery
• hospital services including accommodation and theatre. Excludes any hospital excess you need to pay
• any costs related to anaesthetists and theatre support to assist with the surgery
• rehabilitation, organised by the participating hospital if clinically required.

Please speak to your participating surgeon to make sure you’re aware of and have given Informed Financial Consent for any additional costs.

If you have been charged any out-of-pocket costs and would like to check with HCF, please get in touch with us by calling 13 13 34 or email service@myhcf.com.au.

How do I access the No-Gap Joints program?
To access the program, eligible HCF members need to be accepted into the program in line with clinical criteria by a participating clinician and hospital on a patient by patient basis and undergo their joint replacement surgery before the relevant proposed trial program end date*. Please visit the participating hospital’s page to see the list of surgeons involved in the program.

Can I choose my surgeon? 
You can choose any of the participating No-Gap Joints program surgeons - please visit the participating hospitals to see the list of surgeons in the program. You’ll need to confirm whether the hospital and surgeon is available and they must accept you into the program.

If I change cover or move health funds, is there a waiting period?    
Yes, the program is only available once you’ve held hospital cover that includes primary hip and knee replacements with HCF for 12 months (excluding Overseas Visitors Health Cover)*.   

What if I can’t access or don’t live near one of the participating hospitals? 
If you can’t participate in the No-Gap Joints program, you can still access No-Gap or Known Gap surgeons who participate in our No Gap or Known Gap arrangement. Call us on 13 13 34 to find out more on hospitals and surgeons that are part of our participating network near you. Please note participating surgeons in the No-Gap Joints program have the discretion to choose in line with clinical criteria if members are accepted into the program on a patient-by-patient basis.

When does the No-Gap Joints program end?

The No-Gap Joints program is proposed to end at:

• Hurstville Private Hospital, NSW on 31 March 2025
• East Sydney Private Hospital, NSW on 31 March 2025
• Vermont Private Hospital, Vic on 30 April 2025
• Macquarie University Hospital, NSW on 30 September 2025

You must undergo your joint replacement surgery before the relevant proposed trial program end date.

I have more questions about the No-Gap Joints program – who can I speak to?

For any questions, get in touch with us on 13 13 34 or email service@myhcf.com.au. We aim to get back to you within 2 business days.

Will HCF contact me regarding No-Gap Joints?
As part of our No-Gap Joints program we may email you a short survey about your experiences with HCF and the program. Hearing your feedback will help us improve the services we offer you and other members.

^* Eligible members will need to have HCF hospital cover including primary hip and knee replacements for 12 months (excluding Overseas Visitors Health Cover). Members will be accepted into the program in line with clinical criteria by the participating clinician and hospital on a patient-by-patient basis. Must be admitted at Macquarie University Hospital, East Sydney Private Hospital, Hurstville Private Hospital or Vermont Private Hospital. You must undergo your joint replacement surgery before the proposed trial program end date. The No-Gap Joints Program is proposed to end on 31 March 2025 at Hurstville Private Hospital and East Sydney Private Hospital, 30 April 2025 at Vermont Private Hospital, and 30 September 2025 at Macquarie University Hospital.

⁺ Eligibility criteria applies. For more information see hcf.com.au/hwfl